Chronic Fatigue Syndrome During Pregnancy

What's the difference between normal sleepiness during pregnancy and the debilitating condition known as chronic fatigue syndrome? Here's what you need to know.

Xunbin Pan/Stocksy

Feeling tired while you're pregnant is such a common symptom, you'd probably wonder what was going on if you weren't sleepy at least some of the time during those nine months. But sometimes that drowsiness goes well beyond what's normal and manifests itself as a condition known as chronic fatigue syndrome, or CFS.

Though answers about CFS during pregnancy are pretty hard to come by, one thing is known for sure: It in no way interferes with having a healthy pregnancy and baby.

What is chronic fatigue syndrome?

CFS is a complex chronic condition affecting over a million American men and women of all ages, though women are two to four times more likely to suffer from it than men. While its dominant symptom is, not surprisingly, fatigue, the illness affects so much more than a person’s state of exhaustion. Along with unrelenting tiredness come other symptoms that can include muscle and joint pain, memory lapses, headaches, trouble sleeping and immune problems. All of these may come and go, and they could last for weeks, months or even years. The difficulty with CFS is that it’s hard to diagnose (there aren’t any tests for it, and other illnesses can cause similar symptoms), it’s not known what causes it and there’s no cure.

How does chronic fatigue syndrome affect pregnancy?

Very little is known about the condition’s impact on pregnancy beyond anecdotal evidence, which suggests (no big surprise here), that CFS affects different women differently when they're expecting. Some moms-to-be note their symptoms improve during pregnancy, while others say they get worse. Of course, it may be hard to tell, since pregnancy is physically exhausting for all women, even those not dealing with CFS. Being chronically tired isn’t normal during other times of life, but it can be considered normal when you’re expecting, especially during the first and third trimesters. Still, it’s important not to confuse the fatigue and symptoms of CFS with the typical fatigue of pregnancy. Being tired during pregnancy — even very tired — does not mean you’ve developed CFS, which is characterized by an extreme feeling of exhaustion that is lasting and limits your ability to function as usual.

Happily, moms-to-be with CFS don’t have any higher chances of developing pregnancy complications like preeclampsia, gestational diabetes, premature labor or having a low birthweight baby. That said, they may be up to four times more likely to have a miscarriage and more prone to suffering from morning sickness that lasts all day (as opposed to the kind that only strikes when they wake up). The serious form of pregnancy nausea and vomiting called hyperemesis gravidarum is also more common among expectant moms with CFS.

As for handling the exhaustion of childbirth if you have CFS, moms with the condition may tire more quickly during labor and may have a longer recovery period post-delivery. Postpartum depression may also be more common among new moms with CFS.

How is chronic fatigue syndrome treated during pregnancy?

If you’re pregnant and have been diagnosed with CFS prior to conceiving, it’s important that the doctor who has been caring for your condition knows about your pregnancy and the practitioner you’ve chosen for your prenatal care knows about your CFS. Together, incorporating strategies that have made you feel better in the past — like graded exercise therapy and cognitive behavioral therapy — they will be able to help you cope with your CFS while you’re nurturing your baby-to-be. You’ll also need to take a good look at any medications you’ve been taking to improve symptoms to make sure they're compatible with pregnancy (some — like Midodrine — aren’t).

Just remember that the vast majority of women with CFS can and do have healthy pregnancies and healthy babies. Having the support of a partner, family members and close friends — as well as being under the care of a good therapist and medical team — can help you weather the challenges of suffering from CFS during pregnancy.

From the What to Expect editorial team and Heidi Murkoff, author of What to Expect When You're Expecting. Health information on this site is based on peer-reviewed medical journals and highly respected health organizations and institutions including ACOG (American College of Obstetricians and Gynecologists), CDC (Centers for Disease Control and Prevention) and AAP (American Academy of Pediatrics), as well as the What to Expect books by Heidi Murkoff.

The material on this website is provided for educational purposes only and is not to be used for medical advice, diagnosis or treatment, or in place of therapy or medical care. Use of this site is subject to our terms of use and privacy policy.